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substance misuse and mood disorders

The relationship between substance misuse and mood disorders is a complex one.There is no doubt that the effect drugs have can depend on the mood the person isin before using them and the expectation they have of the outcome. Mood changesare also affected by the type of drug, its strength, frequency of use and withdrawal.Again, individuals with a mood disorder may use substances to self-medicate inorder to achieve some relief from their symptoms. A significant number of peopleadmitted to hospital for a first episode of bipolar disorder had been misusing alcoholfor the year preceding their admission, and this type of history often leads to apoorer outcome for the individual.

Substance misuse should be routinely considered when assessing people withmood disorders. It has been suggested that alcohol misuse and depression may wellbe different expressions of the same underlying cause, depending on gender.Men have a higher incidence of alcoholism and secondary depression, whereasmore women develop alcohol problems following depression. Effective treatmentfor mood disorders has been demonstrated to have a positive impact on alcohol dependence, but there is less evidence to show that the treatment of mood symptomsresults in a reduction of the misuse of other drugs.

By understanding what benefits the service user gets from their non-prescribeddrug misuse, practitioners may be able to suggest alternatives, which includecognitive behavioural approaches, changing prescribed medication and helpingdetoxification.

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